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Author(s):  
Muhammad J. Uddin ◽  
Jesmine Banu ◽  
Shakeela Ishrat ◽  
Sabiha Sultana ◽  
Serajoom Munira ◽  
...  

Background: Ovarian aging may be reversible. Platelet rich plasma (PRP) has growth factors that promote cellular proliferation and folliculogenesis. Recently published studies and case reports suggest that ovarian rejuvenation can be done by PRP treatment. The objective of the study was to evaluate the effect of platelet rich plasma on ovarian reserve markers such as anti mullerian hormone (AMH) and antral follicle count (AFC) in sub fertile women with poor ovarian reserve (POR).Methods: The self-controlled quasi experimental study was carried out on 29 sub fertile women with poor ovarian reserve. They were selected for laparoscopic tubo-peritoneal evaluation as they could not afford in vitro fertilization. During laparoscopy, 5 ml of pre prepared autologous PRP was injected into each ovary. Post-PRP AMH and AFC were measured at every cycle for a period of at least three (3) months and compared with base line values.Results: Mean age of participants was 35.9±3.2 years. Baseline AMH was 0.31±0.17 ng/ml and baseline AFC was 3.41±0.73. AMH was raised on first, second and third cycle from base line values in 58.62%, 86.21% and 91.30% of the study population respectively. AMH changes in all three cycle were statistically significant. Pregnancy occurred in three (10.34%) women during the study period.Conclusions: The injection of autologous PRP into human ovaries is a safe procedure to improve ovarian reserve markers (AMH and AFC) in women with POR.


2022 ◽  
Author(s):  
Mahnaz Ashrafi ◽  
Nadia Jahangiri ◽  
Shahideh Jahanian Sadatmahalleh ◽  
Negin Mirzaei ◽  
Naiiere Gharagozloo Hesari ◽  
...  

Abstract Background Sexuality as a fundamental component of women’s health, can be affected by infertility. The current study aimed at comparing the prevalence of sexual dysfunction among women with the most common causes of infertility. Methods The current cross-sectional study was conducted on 240 infertile females with infertility due to polycystic ovary syndrome (PCOS, n=80), endometriosis (n=80) and male factor (n=80) at Royan Institute for Reproductive Biomedicine (Tehran, Iran) and 160 fertile women at health care centers, between May 2016 and June 2017. Sexual function was assessed by Female Sexual Function Index (FSFI). Data were analyzed using SPSS (version 25.00) and differences were regarded statistically significant at p < 0. 05. Results The prevalence of female sexual dysfunction was 98.8% in women with PCOS, 100.0% in those with endometriosis, and 80.0% in those with male factor infertility. Overall, 36.2% of the enrolled fertile women were suffering from sexual dysfunction. Conclusions There was an association between the prevalence of female sexual dysfunction or individual domain scores of the FSFI, and infertility etiologies. Therefore, infertility care providers are required to take this into consideration and develop preventive strategies in this regard.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Katayoun Bakhtiar ◽  
Arash Ardalan ◽  
Farzad Ebrahimzadeh ◽  
Mohammad Almasian ◽  
Fatemeh Bastami

Background: Depression and sexual dissatisfaction are among the most common psychological factors caused by infertility. Infertility is an essential topic in the Iranian culture, and many studies have already investigated it. Objectives: This study aimed to compare the depression severity and sexual dissatisfaction between fertile and infertile women in Iran. Methods: This case-control study enrolled 180 infertile women and 540 fertile women in 2019. The participants were selected through multistage stratified and cluster sampling methods. For each infertile woman, three fertile women were randomly selected. The data collection instruments consisted of a demographic form, the Depression Inventory Scale (Second Edition), and the Linda Berg Sexual Satisfaction Questionnaire. The multivariate marginal model and SPSS version 21 were used for data analysis at a significance level of 0.05. Results: After adjustment for confounding variables, the marginal model showed that the odds of depression increased by approximately 21.305 times among cases compared to controls (OR = 21.305, 95% CI = 14.75 - 32.021, P < 0.001). This model also found that by moderating the effects of confounding variables, infertility increased the odds of low sexual satisfaction by approximately 15.560 times (OR = 15.560, 95% CI = 5.089 - 47.571, P < 0.001). The chi-square test showed a significant relationship between infertility treatment and depression severity in infertile women (P = 0.001). Conclusions: The overall depression severity and sexual dissatisfaction were higher in the infertile group than in the fertile one. Most cases of severe depression were observed in IVF clinics with higher depression levels. The study may help reveal infertility's psychological and social aspects in Iran.


2021 ◽  
Vol 9 (4) ◽  
pp. 182-188
Author(s):  
Orji Ernest Okechukwu

This study assessed the effect of sexual Dysfunction on the self-esteem between infertile and fertile married women in Ife East Senatorial district Southwest Nigeria. This was a comparative cross-sectional study using both quantitative and qualitative methods of data collection. It was conducted at infertility and family planning clinics of Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife, Nigeria. Using stratified random sampling, 222 infertile women at infertility clinic and 222 family planning clients who met inclusion criteria were recruited from 2020 to 2021. Quantitative data was assessed using the Rosenberg self-esteem questionnaire, while an in-depth interview guide was employed to collect qualitative data. Data were managed using SPSS version 22. P-value was set at P <0.05. Fifty (22.5%) infertile women had low self-esteem compared with five (2.3%) of fertile women. which was statistically significant (P<0.001). Among fertile women, female sexual Dysfunction did not affect self-esteem (P=0.346), but among infertile women, female sexual Dysfunction significantly affected self–esteem (P=0.016). There is a positive relationship between female sexual function index scores and self-esteem scores among fertile and infertile women (r= 0.294 and 0.354 respectively) p<0.001 Sexual dysfunctions among infertile women adversely affected their self-esteem.


Author(s):  
Reenoo Jauhari ◽  
Prashant Mathur ◽  
Vineeta Gupta

Objective: To compare vitamin D status in, women with PCOS & fertile women without PCOS and its subsequent evaluation. Introduction: PCOS is an endocrine disorder of women in reproductive age, characterised by obesity, hyperandrogenaemia and insulin resistance. Women with PCOS tend to be overweight and have increased risk of development of Type II Diabetes and cardiovascular disease. Exact Etiology of PCOS still remain an enigmatic dilemma however various studies conducted till date include diet and lifestyle modification as the key factor to promote health, BMI, reduced hyperinsulinemia and reduce the risk of development of PCOS. Main aim of our study was to compare vitamin D status in women having PCOS, with fertile women in a tertiary care hospital in Uttarakhand. Methodology: The conducted study was cross sectional, involving the enrolment of 100 women comprising of 50 women with PCOS and 50 fertile women without PCOS. Participants were selected from gynaecological OPD at Shri Mahant Indiresh Hospital, associated with Shri Guru Ram Rai Institute of Medical Sciences, Dehradun from July 2019 to January 2020. The diagnostic criteria of PCOS used was the Rotterdam criteria. The serum 25-hydroxy vitamin D and other metabolic markers were measured. Vitamin D deficiency was defined as serum 25 (OH) D concentrations less than 20 ng/ml measured on an instrument named as miniVidas (BioMerieux, Germany) based on ELFA (enzyme linked fluorescent assay). Results: Serum 25-hydroxyvitamin D was significantly lower in women with PCOS compared to fertile controls (p< 0.0001), and the prevalence rates of 25(OH) D deficiency and insufficiency were higher in women with PCOS than in fertile women (p < 0.0001). The study results showed that the prevalence of 25 (OH) D deficiencies in PCOS women was significantly high. Serum 25 (OH) D concentrations were significantly negatively correlated with body mass index (BMI), waist-to-hip ratio (WHR), fasting insulin, total cholesterol and low-density lipoprotein cholesterol (LDL-C), (P < 0.05). In comparison, serum 25 (OH) D concentrations were significantly positively correlated with high-density lipoprotein cholesterol (HDL-C) (P < 0.05). Increased BMI and WHR, high levels of fasting insulin, total cholesterol and LDL-C were regarded as risk factors, but high level of HDL-C was considered to be protective factor of vitamin D deficiency in PCOS women. Conclusion: The study demonstrated that women with PCOS have a significantly lower 25(OH) D compared to fertile controls. A compromised vitamin D status in PCOS women is associated with a higher prevalence and metabolic risk of PCOS in women.


GYNECOLOGY ◽  
2021 ◽  
Vol 23 (5) ◽  
pp. 435-440
Author(s):  
Mekan R. Orazov ◽  
Viktor E. Radzinsky ◽  
Ljudmila M. Mihaleva ◽  
Elena S. Silantieva ◽  
Marina B. Khamoshina ◽  
...  

The most urgent problem of modern gynecology is not just the treatment of intrauterine adhesive disease in fertile women, but the prevention of its recurrence. The lack of a systematic approach to management create grounds for searching for remedies with maximum anti-relapse effectiveness, minimum frequency of side effects. The purpose of the review is to consider the effectiveness of various types of treatment of intrauterine adhesions in women of reproductive age.


2021 ◽  
Vol 71 (5) ◽  
pp. 1844-47
Author(s):  
Amna Shafiq ◽  
Rabiya Akbar ◽  
Uzma Urooj ◽  
Sadaf Zohra ◽  
Shazia Afzal ◽  
...  

Objective: To compare the ovulation induction of letrozole and clomiphene citrate in sub-fertile women with polycystic ovarian syndrome. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital Rawalpindi, from Jun 2018 to Aug 2019. Methodology: A total of 116 married sub-fertile women with polycystic ovarian syndrome, 16-40 years of age were included. Patients with previous surgery related to genital tract, hypothyroidism and chronic renal failure were excluded. Letrozole 5.0mg daily from Day 5-9 of menstruation was prescribed to group A women and clomiphene citrate 100 mg daily from Day 5-9 of menses was given to group B women. Results: In group A and in group B, mean age was 29.78 ± 4.71 years and 29.95 ± 4.22 years respectively. Most of the patients 59 (50.86%) were between 18-30 years of age. Mean duration since marriage was 4.23 ± 1.42 years. Mean body mass index was 29.71 ± 2.65 kg/m2. Frequency of ovulation of clomiphene citrate and letrozole in sub-fertile women with polycystic ovaries was 28 (42.28%) versus 42 (72.41%) respectively (p-value=0.008). Conclusion: This study concluded that ovulation induction of letrozole is better than clomiphene citrate in sub-fertile women with polycystic ovarian syndrome.


2021 ◽  
Vol 10 (21) ◽  
pp. 5086
Author(s):  
Monika Kniotek ◽  
Aleksander Roszczyk ◽  
Michał Zych ◽  
Małgorzata Wrzosek ◽  
Monika Szafarowska ◽  
...  

In our previous study, we showed that sildenafil citrate (SC), a selective PDE5A blocker, modulated NK cell activity in patients with recurrent pregnancy loss, which correlated with positive pregnancy outcomes. It was found that NK cells had a pivotal role in decidualization, angiogenesis, spiral artery remodeling, and the regulation of trophoblast invasion. Thus, in the current study, we determined the effects of SC on angiogenic factor expression and production, as well as idNK cell activity in the presence of nitric synthase blocker L-NMMA. Methods: NK cells (CD56+) were isolated from the peripheral blood of 15 patients and 15 fertile women on MACS columns and cultured in transformation media containing IL-15, TGF-β, and AZA—a methylation agent—for 7 days in hypoxia (94% N2, 1% O2, 5% CO2). Cultures were set up in four variants: (1) with SC, (2) without SC, (3) with NO, a synthase blocker, and (4) with SC and NO synthase blocker. NK cell activity was determined after 7 days of culturing as CD107a expression after an additional 4h of stimulation with K562 erythroleukemia cells. The expression of the PDE5A, VEGF-A, PIGF, IL-8, and RENBP genes was determined with quantitative real-time PCR (qRT-PCR) using TaqMan probes and ELISA was used to measure the concentrations of VEGF-A, PLGF, IL-8, Ang-I, Ang-II, IFN–γ proteins in culture supernatants after SC supplementation. Results: SC downregulated PDE5A expression and had no effect on other studied angiogenic factors. VEGF-A expression was increased in RPL patients compared with fertile women. Similarly, VEGF production was enhanced in RPL patients’ supernatants and SC increased the concentration of PIGF in culture supernatants. SC did not affect the expression or concentration of other studied factors, nor idNK cell activity, regardless of NO synthase blockade.


2021 ◽  
Vol 12 ◽  
Author(s):  
Karolina Piekarska ◽  
Paweł Radwan ◽  
Agnieszka Tarnowska ◽  
Andrzej Wiśniewski ◽  
Michał Radwan ◽  
...  

The mother’s uterine immune system is dominated by uterine natural killer (NK) cells during the first trimester of pregnancy. These cells express killer cell immunoglobulin-like receptors (KIRs) of inhibitory or activating function. Invading extravillous trophoblast cells express HLA-C molecules, and both maternal and paternal HLA-C allotypes are presented to KIRs. Endoplasmic reticulum aminopeptidase 1 (ERAP1) and 2 (ERAP2) shape the HLA class I immunopeptidome. The ERAPs remove N-terminal residues from antigenic precursor peptides and generate optimal-length peptides to fit into the HLA class I groove. The inability to form the correct HLA class I complexes with the appropriate peptides may result in a lack of immune response by NK cells. The aim of this study was to investigate the role of ERAP1 and ERAP2 polymorphisms in the context of KIR and HLA-C genes in recurrent implantation failure (RIF). In addition, for the first time, we showed the results of ERAP1 and ERAP2 secretion into the peripheral blood of patients and fertile women. We tested a total of 881 women. Four hundred ninety-six females were patients who, together with their partners, participated in in vitro fertilization (IVF). A group of 385 fertile women constituted the control group. Women positive for KIR genes in the Tel AA region and HLA-C2C2 were more prevalent in the RIF group than in fertile women (p/pcorr. = 0.004/0.012, OR = 2.321). Of the ERAP polymorphisms studied, two of them (rs26653 and rs26618) appear to affect RIF susceptibility in HLA-C2-positive patients. Moreover, fertile women who gave birth in the past secreted significantly more ERAP1 than IVF women and control pregnant women (p &lt; 0.0001 and p = 0.0005, respectively). In the case of ERAP2, the opposite result was observed; i.e., fertile women secreted far less ERAP2 than IVF patients (p = 0.0098). Patients who became pregnant after in vitro fertilization embryo transfer (IVF-ET) released far less ERAP2 than patients who miscarried (p = 0.0032). Receiver operating characteristic (ROC) analyses indicate a value of about 2.9 ng/ml of ERAP2 as a point of differentiation between patients who miscarried and those who gave birth to a healthy child. Our study indicates that both ERAP1 and ERAP2 may be involved in processes related to reproduction.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Anna Gideon Kasililika ◽  
Akin-Tunde Ademola Odukogbe ◽  
Magbagbeola David Dairo ◽  
Belinda Stella Balandya ◽  
Emmanuel Kulwa Bunuma

Abstract Background Female infertility is a public health problem, contributing to 65.9% of infertility in Tanzania. Lifestyle and oxidative stress (OS) have been suggested to affect female fertility; however, there are limited and controversial reports. This study aimed to determine the lifestyle and OS status of fertile and infertile women and relate lifestyle and OS to female infertility. The study was conducted among randomly selected 48 fertile and 48 infertile women aged 15–49 years attending a gynaecological clinic at Muhimbili National Hospital. Lifestyle information was collected using a proforma, and a sandwich ELISA method was used to analyse OS biomarkers (malondialdehyde and total antioxidant capacity). Chi-square, independent t test and correlation coefficient were used for data analysis at p < 0.05. Results Infertile women were significantly older (33.4 versus 30.3 years, p = 0.03), got married at later ages (25.0 versus 22.8 years, p = 0.02), were in employment (62.5% versus 29.2%, p = 0.001), had attained university degree (56.3% versus 27.1%, p = 0.004) and were more obese, more likely to consume alcoholic drinks (p = 0.02) and less likely to use supplements (p = 0.000) than fertile women. Infertile women had statistically significant higher malondialdehyde (p = 0.000) and lower total antioxidant capacity levels (p = 0.000) than fertile women. The total antioxidant capacity level had a statistically significant negative correlation with alcohol consumption (r = −0.27, p = 0.008) and obesity (r = −0.32, p = 0.002) and a positive correlation with supplement use (r = 0.24, p = 0.02). Also, malondialdehyde level had a statistically significant positive correlation with alcohol consumption (r = 0.31, p = 0.002) and obesity (r = 0.28, p = 0.007). Conclusions The differences in socio-demographic characteristics, lifestyle and oxidative stress between fertile and infertile women may account for difficulties in achieving pregnancy among infertile women in Tanzania. Lifestyle factors significantly affect oxidative stress. Health education on appropriate lifestyles that support female fertility and emphasis on supplement use during the preconception period may be beneficial in the management of female infertility.


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